Job Requirements:
Education: Bachelors Degree required; Master's preferred.
Experience:
At least Five (5) years experience in nursing case management or quality management and at least Three (3) years of management experience in an acute care setting. Licensure /Certification: Current California RN License or equivalent; Certification in Case Management (CCM) within two years of hire.
Job Description:
The Area Director of Case Management and Utilization Review is responsible for the development, planning, coordination and administration of a systematic program designed to appropriately deploy resources for meeting the patient's social service, discharge planning needs, both pre and post discharge, and the Care Transitions Program. Such action taken by the Director will balance both the immediate and long term care needs of the patient with those policies and practices needed to insure the fiscal viability of the ministries. In doing so, the Director is responsible for ensuring that patients are placed in the most appropriate venue for the desired intensity of care; that relevant staff and physician education is comprehensive and timely; and that prospective, concurrent and retrospective utilization review is robust and ongoing.
Successful outcomes to this position are based on facilitating and maintaining strong, positive, mature, and collaborative working relationships with all departments, the Executive Leadership Team, and the Medical Staff. The incumbent works closely with the Chief Financial Officer, Chief Nursing Officers and the medical staff, as well as St. Joseph Health System committees and departments which have responsibilities for Care Management and Clinical Effectiveness. Member of Area Leadership Team.